1. Introduction and background

1.1 Background

Over the last couple of years, access to sanitary products has been raised as a concern by campaigns and stakeholders. [1] The issue has been approached from two main perspectives. Some have focussed on 'period poverty' – underlining that some people living on a low income cannot afford sanitary products. Others, from a gender equality or human rights perspective, argue that menstruation should be normalised and access to sanitary products considered a human right.

Campaigns and news articles report stories of people on a low income struggling to afford sanitary products as well as other essentials. Homelessness, coercive, controlling and violent relationships, and health conditions such as endometriosis, which can cause painful and heavy periods, have been highlighted as circumstances that make menstruation a particularly difficult experience. It has been suggested that lack of access to adequate sanitary protection could lead to health issues, such as toxic shock syndrome and infections. [2] Educational settings are another context in which access to products has been highlighted as difficult. There are anecdotal reports that some girls are missing education in order to manage their menstruation, which could have an impact on educational attainment. [3]

Results from a small number of recent surveys suggest that some people do struggle to afford sanitary products, and have to cope by obtaining sanitary products from friends or family, or using improvised sanitary wear. Women for Independence's Free Period Scotland campaign ran a survey asking about experiences accessing sanitary products. According to a report in the Guardian [4], nearly one in five of the over 1000 respondents said that they have had to go without period products because of finances, while one in 10 said they had been forced to prioritise other essential household items over buying sanitary wear. A survey of young people and students conducted by Young Scot found that around a quarter (26%) of respondents in education said they had 'struggled to access sanitary products' in the previous year. Of those who had experienced difficulty, 60% said that this was because they 'didn't have the product they needed', while 43% said they 'couldn't afford to buy sanitary products'. [5] A survey of a sample of 1,000 14-21 year olds in the UK commissioned by Plan international reported that: 10% of those surveyed had been unable to afford sanitary products, while 15% had struggled to afford sanitary wear. [6]

There is currently little robust data available to estimate how widespread lack of access to sanitary products is in the general population (the Plan International survey is the only one that reports it was based on a representative sample). Living on a low income may be considered a suitable proxy. Many working age adults living in relative poverty are close to the poverty threshold (around a third) [7] and are theoretically less likely to be experiencing difficulty affording basic essentials such as sanitary products. The percentage of women and girls in severe poverty (those with an equivalised income below 50% of the median income) is likely to be the best proxy for being unable to afford sanitary products. However, producing figures for the number of women in poverty is problematic because poverty is measured at the household level. Fourteen percent of working age adults were in severe poverty (after housing costs) in 2014/15-2016/17 in Scotland. [8]

Various estimates have also been made of the average yearly and lifetime costs of sanitary products specifically and periods more generally. A figure that has been widely cited is that women spend more than £18,000 over a lifetime having periods – based on a survey by vouchercodespro.co.uk. [9] However, this includes other spending e.g. pain relief and new underwear as well as sanitary products, and suggests £13 per month for sanitary products based on survey respondents' estimates of how much they spend each month. On the other hand, a BBC calculator estimates a lifetime cost of £1,600 based on starting to menstruate at age 12 and going through menopause at age 51 – this estimate of average usage works out at around £37 per year. [10] Based on an average of 300 products per year and average retail costs of 8p to12p per product, the average annual cost of sanitary products works out as around £24 to £36. This equates to an average lifetime cost for managing menstruation of around £1,000 to 1,500. [11]

1.2 About the pilot

The Scottish Government funded a six month pilot in Aberdeen between September 2017 and February 2018 to explore options for providing access to free sanitary products in ways that provide choice and respect dignity. The pilot aimed to test providing products directly to participants and providing the means for participants to buy products themselves. It also explored both targeted provision for those in low income households and 'universal' provision open to all students in the participating schools, college and university.

Provision for low income households was tested via the third sector. The pilot was run by Community Food Initiatives North East ( CFINE) a social enterprise focused on improving health and wellbeing. CFINE provided access to a range of different types of sanitary products using established relationships with local partners through the FareShare surplus food network. The pilot was initially rolled out in a number of third sector organisations and regeneration areas in Aberdeen. It was later extended, via CFINE, to educational settings – Robert Gordon University, North East Scotland College, three secondary schools and one primary school – and some additional community/third sector partner organisations.

1.2.1 Aims and objectives

The pilot was set up to both gain insight into the issue of lack of access to sanitary products for low income households and students, and to explore options for providing access to free sanitary products for both groups with a particular focus on how this can be done in a dignified manner. The five overarching objectives of the pilot were to:

1. Test different approaches to providing dignified access to free sanitary products for people from low income households and students at school, college and university (including direct provision of products, and providing the means to purchase products where appropriate). Key to this objective is understanding the logistical/operational issues that might arise for providers from the different approaches, as well as the ease of access, choice and level of dignity offered to participants.

2. Provide indicative information on volume, type and quality of products required in the different settings, and costs (including cost of products and administrative costs).

3. Provide indicative information on the circumstances people are in that mean they cannot access sanitary products or have anxiety about being unable to access products, the impacts (both practical and psychological/emotional) of lack of access to products and how people cope without the products they need.

4. Assess the impact of providing access to free sanitary products on participants in the pilot (including on access to adequate sanitary protection, ability to manage their menstruation in a dignified way, impact on attendance at school/college/university/other activities, accessing wider services being offered by service providers, the choices that people make when given the means to purchase products).

5. Assess the wider impact of providing access to free sanitary products on the organisations involved (including on their operating models and their relationships with other partners/service users).

On 8 th March 2018 Scottish Government announced that it would fund continued provision of sanitary products to individuals who had participated in the pilot while the evaluation of the pilot is completed, and extend provision in the schools, college and university, until the end of June 2018.